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UTAH ADDICTION CENTERS NPI 1609130418


NPI Information

NPI: 1609130418
Provider Name: UTAH ADDICTION CENTERS

Former Legal Business Name: INNER-VENTION BEHAVIORAL HEALTH

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 46D2043483

Address:
2590 PRARIE VIEW DRIVE
EAGLE MOUNTAIN, UT
ZIP 84005
Phone: (801) 766-2233
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UTAH ADDICTION CENTERS is a substance abuse rehabilitation facility in Eagle Mountain, UT. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. UTAH ADDICTION CENTERS NPI is 1609130418. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Inner-vention Behavioral Health.

The provider's business location address is:

2590 PRARIE VIEW DRIVE
EAGLE MOUNTAIN, UT
ZIP 84005
Phone: (801) 766-2233

The provider's authorized official is Darron Quentin Boberg .
The authorized official title is President/owner and has the following contact phone number (801) 766-2233.

The CLIA number assigned to this NPI record is 46D2043483 - other - residential treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/26/2012 and was last updated on 4/17/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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